Provider Demographics
NPI:1992075964
Name:COLOMBINO, ALAYNA (PTA)
Entity type:Individual
Prefix:
First Name:ALAYNA
Middle Name:
Last Name:COLOMBINO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:ALAYNA
Other - Middle Name:
Other - Last Name:GIANUNZIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:WI
Mailing Address - Zip Code:54521-8835
Mailing Address - Country:US
Mailing Address - Phone:715-479-0224
Mailing Address - Fax:715-479-0398
Practice Address - Street 1:201 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:WI
Practice Address - Zip Code:54521-8835
Practice Address - Country:US
Practice Address - Phone:715-479-0224
Practice Address - Fax:715-479-0398
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI184219225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant